MEDICARE: DONALD F LANGENBECK JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	33620	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0486290001	OTHER		DME
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306838495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD F LANGENBECK JR. M.D.

Provider Business Mailing Address
First Line	:	2001 PEACHTREE RD NE
Second Line	:	STE 705
City	:	ATLANTA
State	:	GA
Zip	:	30309-1476
Country	:	US
Telephone Number	:	404-355-0743
Fax Number	:	904-355-2136

Provider Business Practice Location Address
First Line	:	1901 PHOENIX BLVD
Second Line	:	STE 200
City	:	COLLEGE PARK
State	:	GA
Zip	:	30349-5588
Country	:	US
Telephone Number	:	404-355-0743
Fax Number	:	770-991-6477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	02/19/2010

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